Comparison of myopic progression in Finnish and Singaporean children

Abstract

Purpose To compare 3‐year myopic progression between Finnish and Singaporean children. Methods Myopic progression was compared between 9‐year‐old (mean age 9.7 ± 0.4 years, n = 92) and 11‐year‐old (mean age 11.7 ± 0.4 years, n = 144) Finnish (Finnish RCT) children and Singaporean children matched by age and refraction (SCORMMatched, n = 403) and 7‐ to 8‐year‐old Singaporean children matched only by refraction (SCORM Young, n = 186). Spherical equivalent (SE) was between −0.50 and −3.00 D. Refraction with cycloplegia was controlled annually for 3 years. Information on parental myopia, mother’s education, time spent on near‐work and outdoor time was gathered by parental questionnaire. Results Three‐year myopic progression was −2.08 ± 0.96 D and −1.30 ± 0.69 D in the Finnish RCT and Singaporean SCORM Matched 9‐year‐olds, respectively, and −1.34 ± 0.78 D, and −0.52 ± 0.44 D in the 11‐year‐olds, respectively (p < 0.001 between all groups). Myopic progression was fastest (−2.69 ± 0.89 D) in the SCORM 7‐year‐olds and similar between the SCORM Matched 9‐year‐olds and Finnish RCT 11‐year‐olds (p = 0.55). The Finnish RCT and SCORM Matched children showed significant differences in both daily near‐work time (1.8 ± 1.0 versus 3.4 ± 1.9 hours per day, p < 0.001) and outdoor time (2.6 ± 0.9 versus 0.5 ± 0.4 hours per day, p < 0.001). These differences did not, however, explain the differences in myopic progression between the groups. More time spent outdoors was associated with less myopic progression in the Finnish RCT (r = 0.17, p = 0.009) group only. In the whole materials, greater myopic progression was associated with younger age at baseline (p < 0.001), younger age was associated with mother’s higher education (p < 0.001), and mothers higher education was associated with myopia in both parents (p < 0.001). Conclusion Age at baseline was the most significant factor associated with myopic progression. However, at the same age and with the same initial refraction, the Finnish and Singaporean children showed different myopic progression. This result remains unexplained. Thus, age of myopia onset should be considered when comparing myopic progression between different samples and conducting treatment trials. Parental myopia may be a weak indicator of heredity of myopia.

Annual Myopia Progression and Subsequent 2-Year Myopia Progression in Singaporean Children

“… 32 In a recent study, age at baseline was the most significant factor contributing to the 3-year progression of myopia in both Singaporean and Finnish children. 33 Overall, our results seem to indicate that myopia progression can be determined by faster myopia progression at a younger age; however, age of myopia onset was not associated with 2-year myopia progression in our study. Further longitudinal studies on myopia progression from childhood to adulthood are necessary to uncover the link among age, age of myopia onset, and myopia progression.…”

Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute

“…10,120 The effect of parental myopia on myopia in their offsprings may not be taken as proof for a genetic contribution to myopia, since the correlation might also be the result of a shared lifestyle 121 and their higher education. 71 However, parental myopia was associated with a greater risk of early-onset myopia in a recent study. 75 Cognitive functions and education.…”

“…An early age of onset of myopia appears to be the strongest predictor of high myopia in both Asians and White children. [71][72][73][74] It was recently shown that parental myopia was associated with a greater risk of early-onset myopia in Asian, Hispanic, non-Hispanic white, and African American children. 75 In children younger than 6 years of age the prevalence of myopia is low.…”

“… 70 Interestingly, in a recent study comparing Finnish and Singaporean children of the same age group, the 3-year myopia progression was faster among Finnish children. 71 …”

Bayesian Meta-Analysis of Myopia Control with Multifocal Lenses

“…There is convincing evidence that the rate of myopia progression is related to age and possibly to existing level of myopia (e.g., Ref. [60]). Therefore, the use of progressive spectacle lenses having a moderate range of addition powers for myopia control in children and juveniles would only be moderately effective in the first year if applied for the first time to a 10-year-old who has already passed the half-way point on their march to high myopia (−5.0 D).…”